α-硫辛酸对糖尿病周围神经病变患者循环内皮祖细胞数量的影响

发布时间：2018-06-27 21:38

本文选题：2型糖尿病 + 糖尿病血管并发症　；参考：《河北医科大学》2015年硕士论文

【摘要】：目的:内皮祖细胞(EPCs)是血管内皮修复的重要物质,EPCs数量和功能的下降是2型糖尿病并发症的主要原因之一,本研究旨在探讨α-硫辛酸(ALA)对糖尿病周围神经病变患者循环EPCs数量的影响,并探讨其机制,为糖尿病慢性并发症的预防及治疗提供依据。方法:1选择2014年8月至2015年1月收入院的50例2型糖尿病合并糖尿病周围神经病变患者,其中男性31例,女性19例,均符合2009年中国糖尿病周围神经病变诊疗规范提出的糖尿病周围神经病变的诊断标准,详细记录患者性别、年龄、病程、身高及体重。患者降糖药物均为胰岛素,口服他汀类药物保护血管内皮治疗,待患者空腹血糖7.0mmol/L、餐后2h血糖10.0mmol/L,血压控制在140/80mm Hg左右,将入选对象随机分为两组:1)对照组(Control Group):应用丹参酮IIA磺酸钠、甲钴胺、前列地尔组(Con,n=20);2)硫辛酸组(ALA Group):在对照组基础上联合α-硫辛酸(ALA,n=30),治疗时间均为2周。观察治疗前后两组患者EPCs数量及氧化应激指标的变化,并探讨他们之间的关系。2采用流式细胞仪检测EPCs(CD34+/VEGFR2+)数量;3采用酶法测甘油三酯(TG)、总胆固醇(T-CHO)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C),测定超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)的活性,采用硫代巴比妥酸法测定丙二醛(MDA),采用ELISA酶联免疫吸附试验法检测8-羟基脱氧鸟苷(8-OHd G)的变化情况。4所有数据处理均应用SPSS17.0软件分析,计量资料采用t检验及非参数检验,相关分析采用多元线性回归分析。结果:1两组治疗前比较两组间年龄(Age)、性别(Sex)、糖尿病病程、收缩压(SBP)、舒张压(DBP)、体重指数(BMI)、空腹血糖(FBG)、糖化血红蛋白(Hb A1c)、TG、T-CHO、LDL-C、HDL-C、EPCs数量、SOD、GSH-PX、MDA、8-OHd G相比无差异(P0.05)。2对照组(Con)EPCs数量治疗前后相比无差异(P0.05);SOD、GSH-PX、MDA、8-OHd G治疗前后相比无差异(P0.05);TG、T-CHO、LDL-C治疗后较治疗前明显下降,HDL-C治疗后较治疗前显著升高,差异有统计学意义(P0.05)。3硫辛酸组(ALA)EPCs数量治疗后较治疗前明显增加,差异有统计学意义(P0.05);SOD、GSH-PX治疗后较治疗前活性明显增加,差异有统计学意义(P0.05);MDA、8-OHd G水平治疗后较治疗前含量明显减低,差异有统计学意义(P0.05);TG、T-CHO、LDL-C治疗后较治疗前明显下降,HDL-C治疗后较治疗前明显升高,差异有统计学意义(P0.05)。4两组治疗后比较治疗后EPCs数量硫辛酸组较对照组明显增加,差异有统计学意义(P0.05);SOD、GSH-PX硫辛酸组较对照组活力明显增加,差异有统计学意义(P0.05);MDA、8-OHd G水平硫辛酸组较对照组含量明显减低,差异有统计学意义(P0.05);TG、T-CHO、LDL-C、HDL-C两组相比无差异(P0.05)。5两组治疗前后相关指标差值的比较两组EPCs数量治疗前后差值相比,硫辛酸组较对照组明显增加,差异有统计学意义(P0.05);SOD、GSH-PX硫辛酸组较对照组活性明显增加,差异有统计学意义(P0.05);MDA、8-OHd G水平硫辛酸组较对照组含量明显减低,差异有统计学意义(P0.05);TG、T-CHO、LDL-C、HDL-C相比无差异(P0.05)。6 EPCs数量与相关参数的相关性以硫辛酸组EPCs治疗前后数量的差值作为因变量,硫辛酸组SOD、GSH-PX、MDA、8-OHd G、TG、T-CHO、LDL-C、HDL-C、FBG治疗前后的差值作为自变量进行多元线性回归分析,经逐步拟合,最优回归方程为:Y=6.349+0.195X2-3.335X3,X2代表GSH-PX的差值(P=0.01),X3代表MDA的差值(P=0.041),内皮祖细胞数目与GSH-PX、MDA有相关性。结论:1糖尿病周围神经病变患者经ALA治疗后,EPCs数量明显增加;2 ALA可以改善糖尿病周围神经病变患者氧化应激水平,恢复抗氧化酶SOD、GSH-PX活性,减低MDA、8-OHd G的含量;3 ALA增加EPCs的数量与氧化应激相关。
[Abstract]:Objective: endothelial progenitor cells (EPCs) is an important substance in vascular endothelial repair. The decrease of EPCs number and function is one of the main causes of complications of type 2 diabetes. This study aims to explore the effect of alpha lipoic acid (ALA) on the number of circulatory EPCs in patients with diabetic peripheral neuropathy, and to explore its mechanism for the prevention and prevention of chronic diabetic complications. Methods: 1 to select 50 patients with type 2 diabetes with diabetic peripheral neuropathy from August 2014 to January 2015, including 31 male and 19 female, which were all in line with the diagnostic criteria of the diabetic peripheral neuropathy around the diabetic peripheral neuropathy in 2009, and the patient's sex was recorded in detail. Age, course of disease, height and weight. The patients with hypoglycemic drugs were insulin, oral administration of statins to protect vascular endothelium, pending fasting blood glucose 7.0mmol/L, postprandial 2H blood glucose 10.0mmol/L, blood pressure control at 140/80mm Hg, and randomly divided into two groups: 1) group (Control Group): the application of tanshinone IIA sulfonic acid sodium, Mecobalamin, pre Mecobalamin, The group (Con, n=20); 2) sulfur octanic acid group (ALA Group): Based on the control group, combined with alpha lipoic acid (ALA, n=30), the treatment time was 2 weeks. The changes in the number of EPCs and oxidative stress in two groups of patients were observed before and after treatment, and the relationship between them and the number of EPCs (CD34+/VEGFR2+) detected by the flow cytometry was explored; 3 by enzyme method. Oil three ester (TG), total cholesterol (T-CHO), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), the activity of superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), the determination of malonaldehyde (MDA) by thiobarbituric acid method, and the determination of 8- hydroxy deoxy guanosine (8-OH) by the enzyme linked immunosorbent assay (8-OH). The changes in D G) all data processing in.4 were analyzed by SPSS17.0 software. The measurement data were examined by t test and nonparametric test, and multivariate linear regression analysis was used. Results 1 groups of two groups were compared with two groups of age (Age), sex (Sex), diabetes course, systolic pressure (SBP), diastolic pressure (DBP), body mass index (BMI), and fasting blood glucose (FBG). Glycosylated hemoglobin (Hb A1c), TG, T-CHO, LDL-C, HDL-C, EPCs quantity, SOD, GSH-PX, MDA, 8-OHd G before and after treatment. The difference has statistical significance (P0.05).3 sulphate octanic acid group (ALA) EPCs number after treatment significantly increased compared with before treatment, the difference was statistically significant (P0.05); SOD, GSH-PX after treatment significantly increased before treatment, the difference was statistically significant (P0.05); MDA, 8-OHd G level after treatment was significantly lower than before treatment, the difference was statistically significant. (P0.05); TG, T-CHO, LDL-C after treatment was significantly lower than before treatment, HDL-C treatment was significantly higher than before treatment, the difference was statistically significant (P0.05).4 two group after treatment, the number of EPCs in the group of lipoic acid was significantly increased compared with the control group, the difference was statistically significant (P0.05); SOD, GSH-PX sulphate octanic acid group than the control group activity significantly increased, the difference was Statistical significance (P0.05); MDA, 8-OHd G level of lipoic acid group was significantly lower than the control group, the difference was statistically significant (P0.05); TG, T-CHO, LDL-C, HDL-C two groups compared with the difference (P0.05).5 two groups before and after treatment of the difference between the two groups before and after the difference between the number of EPCs, the group of sulphur octanic acid was significantly higher than the control group, the difference was Statistical significance (P0.05); SOD, GSH-PX lipoic acid group activity significantly increased compared with the control group, the difference was statistically significant (P0.05); MDA, 8-OHd G level of sulphur octanoic acid group content was significantly lower than the control group, the difference was statistically significant (P0.05); TG, T-CHO, LDL-C, HDL-C phase and relative parameters of the correlation with the related parameters of sulphur octanoic acid group The difference value of the number of Cs before and after treatment was used as the dependent variable. The difference values of SOD, GSH-PX, MDA, 8-OHd G, TG, T-CHO, LDL-C, HDL-C, and FBG were used as multivariate linear regression analysis before and after the treatment. The number of progenitor cells was associated with GSH-PX and MDA. Conclusion: 1 patients with diabetic peripheral neuropathy were treated with ALA, and the number of EPCs increased significantly. 2 ALA could improve the level of oxidative stress in diabetic peripheral neuropathy, restore antioxidant enzyme SOD, GSH-PX activity, reduce the content of MDA, 8-OHd G; 3 ALA increase the number of EPCs and oxidative stress. Close.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.2

【相似文献】